One of the major issues facing flagship health insurance scheme Ayushman Bharat has been fraudulent practices by empanelled hospitals. At the time of writing, 111 hospitals have been de-empanelled – and to deter further corrupt practices by empanelled hospitals, the Centre will name and shame them on the official Ayushman Bharat website.
“As part of the government’s zero-tolerance towards corruption,” explained Union Health Minister Dr Harsh Vardhan, “names of 111 hospitals, which have been de-empanelled…have been put up on the official website of the AB-PMJAY [Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana] as a part of our ‘name and shame’ policy.”
The policy comes as almost 1,200 instances of fraud have been confirmed under the scheme, with action taken against 338 empanelled hospitals. “We will not tolerate anything that will hamper the integrity of the scheme,” Vardhan added. The most cases of fraud were recorded in Gujarat.
So far, more than Rs 1.5 crore worth of fines have been recouped from corrupt hospitals and legal cases have been filed against six. Past instances of fraud have included “a single doctor conducting surgeries in four districts on the same day, patients charged for expensive procedures not conducted on them, multiple surgeries conducted on a single day late in the night, hysterectomies on men and fake beneficiaries issued cards” according to The Economic Times.
At the time of writing, 18,073 hospitals have been empanelled under the scheme of which 53 percent belong to the private sector. Vigilance against fraud is a central component of Ayushman Bharat going forward, with those implicated in corruption being blacklisted from participation in any government-run scheme. Fraud takes place outside of hospitals too, with fake websites and apps being set up to encourage individuals to pay for beneficiary cards — a popular route taken by scammers.
“Ayushman Bharat is being governed on a zero-tolerance approach towards any kind of fraud,” said Vardhan. “The anti-fraud framework rests on three key pillars of prevention, detection and deterrence.”